New Malnutrition Strategies Could Mean Improved Diagnosis and Treatment

March 22, 2010

A new consensus statement on adult malnutrition could lead to improved diagnosis and treatment of malnutrition. Advocated by an international group of nutrition researchers, the statement is being published in March by two major journals, Clinical Nutrition and the Journal of Parenteral and Enteral Nutrition, and has already been formally endorsed by both the European Society for Parenteral and Enteral Nutrition and the American Society for Parenteral and Enteral Nutrition.

“Depending upon the criteria that are used, up to 50 percent of patients in hospitals or skilled nursing facilities have been estimated to be malnourished,” says Dr. Gordon Jensen, professor and head of the Department of Nutritional Sciences at Penn State and principal author on the paper.

Even though malnutrition has such far-reaching impact, there has been widespread confusion in the clinical community surrounding how to best identify malnutrition. Patients who are malnourished are frequently not recognized as malnourished and those not malnourished are sometimes thought to be malnourished.

Part of this confusion has to do with the body’s inflammatory response, which is the how the body fights disease, injury, and infection. There are many forms of malnutrition, and those related to injury or disease often lead to loss of muscle and diminished function.

“We’re taking a new starting point that we can all agree on, and one that is based on our modern understanding of malnutrition and inflammation,” says Jensen. Since there are no universally accepted definitions for many of the terms used to describe different types of malnutrition, Jensen and his co-authors propose replacing the existing terminology with a new, simplified strategy for diagnosing malnutrition.

Using the newly proposed diagnosis strategy, each person affected by malnutrition would fall into one or more of three categories of malnutrition: starvation-related, chronic disease-related, or acute disease/injury–related. This simple approach is expected to lead to improved diagnosis and treatment.

The international consensus committee is now working on the development of supporting diagnostic criteria.

The guideline committee that wrote the consensus paper includes researchers from Canada, the United States, Brazil, New Zealand, Denmark, South Africa, Mexico, Australia, Paraguay, and the United Kingdom.

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Editors: Gordon Jensen can be reached at glj1@psu.edu. For additional information, please contact the College of Health and Human Development Office of College Relations at 814-865-3831 or healthhd@psu.edu.